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Multiple Sclerosis International
Volume 2014, Article ID 686045, 8 pages
Research Article

Association between Smoking and Health Outcomes in Postmenopausal Women Living with Multiple Sclerosis

1Department of Epidemiology and Community Health, Virginia Commonwealth University School, Richmond, VA 23284, USA
2Department of Neurology, Virginia Commonwealth University School, Richmond, VA 23284, USA
3Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI 02861, USA
4Department of Epidemiology, University of Alabama Birmingham, Birmingham, AL 35294, USA
5Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
6Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA

Received 7 December 2013; Revised 10 March 2014; Accepted 19 March 2014; Published 22 April 2014

Academic Editor: S. Jacobson

Copyright © 2014 Rachel Jawahar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. In multiple sclerosis (MS), symptom management and improved health-related quality of life (HrQOL) may be modified by smoking. Objective. To evaluate the extent to which smoking is associated with worsened health outcomes and HrQOL for postmenopausal women with MS. Methods. We identified 251 Women’s Health Initiative Observational Study participants with a self-reported MS diagnosis. Using a linear model, we estimated changes from baseline to 3 years for activities of daily living, total metabolic equivalent tasks (MET) hours per week, mental and physical component scales (MCS, PCS) of the SF-36, and menopausal symptoms adjusting for years since menopause and other confounders. Results. Nine percent were current and 50% past smokers. Age at smoking initiation was associated with significant changes in MCS during menopause. PCS scores were unchanged. While women who had ever smoked experienced an increase in physical activity during menopause, the physical activity levels of women who never smoked declined. Residual confounding may explain this finding. Smoking was not associated with change in menopausal symptoms during the 3-year follow-up. Conclusion. Smoking was not associated with health outcomes among post-menopausal women with MS.